{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:39:59Z","timestamp":1782545999546,"version":"3.54.5"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Ewing\u2019s sarcoma in the intradural and extramedullary space is exceedingly rare. Here, the authors report a rare case of skip metastasis of intradural extramedullary Ewing\u2019s sarcoma in the lumbar spine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 73-year-old man underwent surgery at another hospital for an intradural extramedullary spinal tumor at the L4 level, initially suspected to be a schwannoma. However, postoperative histopathological examination revealed Ewing\u2019s sarcoma; subsequently, he received local radiotherapy and chemotherapy. Thirty-eight months postoperatively, the patient developed severe low back pain and bilateral leg pain, accompanied by urinary retention and bowel dysfunction. MRI showed a new intradural extramedullary tumor at the L1 level. Gross-total resection was performed, and histopathological examination confirmed Ewing\u2019s sarcoma. Four months after the second surgery, MRI of the lumbar spine revealed tumor recurrence. The patient remained asymptomatic and was treated with additional radiotherapy and chemotherapy, resulting in significant tumor size reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case highlights the aggressive nature of intradural extramedullary Ewing\u2019s sarcoma and its propensity for early recurrence and metastasis. Although this presentation is extremely rare, postoperative adjuvant radiotherapy and chemotherapy, including craniospinal irradiation, should be considered to reduce recurrence risk. Frequent follow-up imaging is essential for the early detection of metastatic disease.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25361\">https:\/\/thejns.org\/doi\/10.3171\/CASE25361<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25361","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T06:35:55Z","timestamp":1754289355000},"source":"Crossref","is-referenced-by-count":1,"title":["Skip metastasis of intradural Ewing\u2019s sarcoma in the lumbar spine: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Junya","family":"Kusakabe","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9644-054X","authenticated-orcid":true,"given":"Ko","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9934-9656","authenticated-orcid":true,"given":"Takahiro","family":"Onoki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9705-0201","authenticated-orcid":true,"given":"Kohei","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Yahata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1634-3945","authenticated-orcid":true,"given":"Tomonori","family":"Kawaharada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimi","family":"Aizawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"Eur J Radiol","first-page":"159","article-title":"Spinal tumors","volume":"50","author":"Van Goethem","year":"2004","unstructured":"Van Goethem JWMvan den Hauwe LOzsarlak ODe Schepper AMParizel PM.Spinal tumors. Eur J Radiol. 2004;50(2):159-176."},{"issue":"2","key":"bib2","series-title":"N Engl J Med","first-page":"154","article-title":"Ewing\u2019s sarcoma","volume":"384","author":"Riggi","year":"2021","unstructured":"Riggi NSuv\u00e0 MLStamenkovic I.Ewing\u2019s sarcoma. N Engl J Med. 2021;384(2):154-164."},{"key":"bib3","series-title":"Clin Neurol Neurosurg","first-page":"12","article-title":"Primary intradural Ewing\u2019s sarcoma of the spine: a systematic review of the literature","volume":"177","author":"Lu","year":"2019","unstructured":"Lu VMGoyal AAlvi MAKerezoudis PHaddock MGBydon M.Primary intradural Ewing\u2019s sarcoma of the spine: a systematic review of the literature. Clin Neurol Neurosurg. 2019;177:12-19."},{"issue":"4","key":"bib4","series-title":"Spine J","first-page":"e7","article-title":"Magnetic resonance image findings of primary intradural Ewing sarcoma of the cauda equina: case report and review of the literature","volume":"14","author":"Lozupone","year":"2014","unstructured":"Lozupone EMartucci MRigante LGaudino SDi Lella GMColosimo C.Magnetic resonance image findings of primary intradural Ewing sarcoma of the cauda equina: case report and review of the literature. Spine J. 2014;14(4):e7-e11."},{"issue":"6","key":"bib5","series-title":"Turk Neurosurg","first-page":"943","article-title":"Cervical primary Ewing\u2019s sarcoma in intradural and extramedullary location and skip metastasis to cauda Equina","volume":"25","author":"Gong","year":"2015","unstructured":"Gong HSHuang QSLiu GJChen FHZhao HB.Cervical primary Ewing\u2019s sarcoma in intradural and extramedullary location and skip metastasis to cauda Equina. 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Sarcoma. 2012;2012:780129."},{"issue":"2","key":"bib8","series-title":"J Neurooncol","first-page":"351","article-title":"Craniospinal irradiation for CNS leukemia: rates of response and durability of CNS control","volume":"166","author":"Ebadi","year":"2024","unstructured":"Ebadi MMorse MGooley TCraniospinal irradiation for CNS leukemia: rates of response and durability of CNS control. J Neurooncol. 2024;166(2):351-357."},{"issue":"5","key":"bib9","series-title":"Cancers (Basel)","first-page":"1209","article-title":"The role of neuroaxis irradiation in the treatment of intraspinal Ewing sarcoma: a review and meta-analysis","volume":"14","author":"Troschel","year":"2022","unstructured":"Troschel FMKr\u00f6ger KSiats JJRahbar KEich HTScobioala S.The role of neuroaxis irradiation in the treatment of intraspinal Ewing sarcoma: a review and meta-analysis. Cancers (Basel). 2022;14(5):1209."},{"key":"bib10","series-title":"Ther Adv Med Oncol","first-page":"17588359241297868","article-title":"Case report: successful treatment of primary intradural extramedullary extraskeletal Ewing sarcoma in adult patient with intralesional surgery, chemotherapy, and proton beam therapy of the cerebrospinal axis","volume":"16","author":"Ziomek","year":"2024","unstructured":"Ziomek MPlaczke JUrbanek KSk\u00f3ra TRutkowski PSpa\u0142ek MJ.Case report: successful treatment of primary intradural extramedullary extraskeletal Ewing sarcoma in adult patient with intralesional surgery, chemotherapy, and proton beam therapy of the cerebrospinal axis. Ther Adv Med Oncol. 2024;16:17588359241297868."},{"issue":"2","key":"bib1","series-title":"Eur J Radiol","first-page":"159","article-title":"Spinal tumors","volume":"50","author":"Van Goethem","year":"2004","unstructured":"Van Goethem JWMvan den Hauwe LOzsarlak ODe Schepper AMParizel PM.Spinal tumors. 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Turk Neurosurg. 2015;25(6):943-947."},{"issue":"8","key":"bib6","series-title":"Spinal Cord","first-page":"582","article-title":"A rare case of intradural extramedullary Ewing\u2019s sarcoma with skip metastasis in the spine","volume":"46","author":"Haresh","year":"2008","unstructured":"Haresh KPChinikkatti SKPrabhakar RA rare case of intradural extramedullary Ewing\u2019s sarcoma with skip metastasis in the spine. Spinal Cord. 2008;46(8):582-584."},{"key":"bib7","series-title":"Sarcoma","first-page":"780129","article-title":"Assessment of minimal residual disease in Ewing sarcoma","volume":"2012","author":"Wagner","year":"2012","unstructured":"Wagner LMSmolarek TASumegi JMarmer D.Assessment of minimal residual disease in Ewing sarcoma. Sarcoma. 2012;2012:780129."},{"issue":"2","key":"bib8","series-title":"J Neurooncol","first-page":"351","article-title":"Craniospinal irradiation for CNS leukemia: rates of response and durability of CNS control","volume":"166","author":"Ebadi","year":"2024","unstructured":"Ebadi MMorse MGooley TCraniospinal irradiation for CNS leukemia: rates of response and durability of CNS control. J Neurooncol. 2024;166(2):351-357."},{"issue":"5","key":"bib9","series-title":"Cancers (Basel)","first-page":"1209","article-title":"The role of neuroaxis irradiation in the treatment of intraspinal Ewing sarcoma: a review and meta-analysis","volume":"14","author":"Troschel","year":"2022","unstructured":"Troschel FMKr\u00f6ger KSiats JJRahbar KEich HTScobioala S.The role of neuroaxis irradiation in the treatment of intraspinal Ewing sarcoma: a review and meta-analysis. Cancers (Basel). 2022;14(5):1209."},{"key":"bib10","series-title":"Ther Adv Med Oncol","first-page":"17588359241297868","article-title":"Case report: successful treatment of primary intradural extramedullary extraskeletal Ewing sarcoma in adult patient with intralesional surgery, chemotherapy, and proton beam therapy of the cerebrospinal axis","volume":"16","author":"Ziomek","year":"2024","unstructured":"Ziomek MPlaczke JUrbanek KSk\u00f3ra TRutkowski PSpa\u0142ek MJ.Case report: successful treatment of primary intradural extramedullary extraskeletal Ewing sarcoma in adult patient with intralesional surgery, chemotherapy, and proton beam therapy of the cerebrospinal axis. Ther Adv Med Oncol. 2024;16:17588359241297868."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/5\/article-CASE25361.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/5\/article-CASE25361.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/5\/article-CASE25361.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:09:43Z","timestamp":1769684983000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/5\/article-CASE25361.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":20,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/case25361","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}